| Entity Name: | POOVENDRAN REGENERATIVE ORTHOPEDIC INSTITUTE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 13 Apr 2023 (2 years ago) |
| Document Number: | L23000184443 |
| FEI/EIN Number | 92-3550401 |
| Address: | 10650 W State Road 84, Ste 111, Davie, FL, 33324, US |
| Mail Address: | 10290 NE 2nd Ave, Miami Shores, FL, 33138, US |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457139974 | 2023-09-18 | 2023-09-18 | 10650 W STATE ROAD 84 STE 111, DAVIE, FL, 333244235, US | 10650 W STATE ROAD 84 STE 111, DAVIE, FL, 333244235, US | |||||||||||||
|
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| Phone | +1 305-209-1951 |
Authorized person
| Name | DR. GAYAN POOVENDRAN |
| Role | OWNER/MEDICAL DIRECTOR |
| Phone | 3052091951 |
Taxonomy
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Bosch Susan | Agent | 10290 NE 2nd Ave, Miami Shores, FL, 33138 |
| Name | Role | Address |
|---|---|---|
| POOVENDRAN GAYAN | Manager | 10650 W State Road 84, Davie, FL, 33324 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000065242 | PRO INSTITUTE | ACTIVE | 2023-05-25 | 2028-12-31 | No data | 10290 NE 2ND AVE, MIAMI SHORES, FL, 33138 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-18 | 10650 W State Road 84, Ste 111, Davie, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-18 | 10650 W State Road 84, Ste 111, Davie, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2024-04-18 | Bosch, Susan | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-04-18 | 10290 NE 2nd Ave, Miami Shores, FL 33138 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| Florida Limited Liability | 2023-04-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
